Project Summary: Native Transformations Opioid Project Abuse of opioids (e.g. heroin and prescription painkillers) constitutes a national public health crisis. Recent research shows a steep increase in deaths due to opioid overdose and in Hepatitis C infection in Washington State, with the highest rates reported in Whatcom County, which is the home of the Lummi Nation, the state?s third largest tribe with approximately 5,100 members. Data from the Lummi Nation enrollment division show that for the 18 Tribal member deaths occurring in the first seven months of this year (2016), five of were opioid- related, accounting for 28% of all deaths this year with the average age of the deceased being 29 years. The proposed Native Transformations Opioid Project (NTOP) seeks to develop research capacity at Northwest Indian College (NWIC) and its surrounding tribal communities to develop effective and culturally congruent strategies to reduce the burden of death from opioid and other drug-related overdoses in tribal communities in the Pacific Northwest. Building on our successful Native Transformations Project (NTP) research collaboration with three Coast Salish Tribes?Lummi Nation, Swinomish Indian Tribal Community and Upper Skagit Indian Tribe?NTOP seeks to develop tools to address the problem of opioid use disorder (OUD) by identifying factors associated with recovery. The primary aim of the proposed project is to identify the strengths and behavioral strategies in successful recovery from OUD in these three Coast Salish communities. The ultimate goal of the proposed research is to identify Coast Salish recovery factors from OUD to develop a data-driven, culturally congruent intervention to reduce OUD and OUD overdose deaths. The research and its approach have relevance and are generalizable as a model for other communities in developing culturally-based interventions for OUD as well as in creating theory driven, culturally-appropriate outcome measures to evaluate existing and new OUD services. In order to address existing OUD disparities, the proposed NTOP study will build on the success of the NTP, using a mixed-methods approach within a tribally engaged and controlled framework, to address the following specific aims (SA): SA1. Understand risk, resilience, and recovery factors specific to OUD by conducting life history interviews (LHI) with Coast Salish adults in recovery from OUD. SA2. Use the LHI data to modify the existing NTP recovery factors model and to develop an assessment tool aligned to this model to measure Coast Salish recovery factors specific to OUD. SA3. Test the factor structure, reliability, and validity of this inventory of OUD recovery factors for its potential utility in tribal community-based OUD clinical settings. SA4. Provide place-based research training and career enhancement opportunities in an area of highest tribal health priority for AIAN students attending NWIC and University of Alaska Fairbanks.